Approximately two million burn injury cases require medical attention on a yearly basis in the United States alone, with 20,000 of these cases requiring admission to specialized burn centers. One of the foremost causes of morbidity and mortality in the burn patient is infection. Indeed, for those patients with burn size greater than 40% of total body surface area, 75% of all deaths are due to infection. Thus, implementing effective strategies for infection prevention and avoiding transmission of resistant microorganisms from patient to patient is a critical barrier in the treatment of burn patients. A foundational element of avoiding systemic infection in the burn patient lies with preventing infection of the burn wound itself. Unfortunately, the burn wound is an attractive media for the growth of all types of microorganisms as loss of overlying skin creates a moist, protein-rich, avascular environment that facilitates microbiotic growth. Current, standard-of-care strategies for the prevention of burn wound infection involve the use of topical antimicrobials, but these topical agents do no kill 100% of microorganisms and display a variety of untoward effects in burn patients. SuperPulse Plasma Processing Technology (SuperPulse PPT) has developed totally novel, non-thermal plasma delivered free radical sterilization system that is a side effect-free alternative to topical antimicrobials for the prevention of burn wound infection. The mechanism behind SuperPulse PPT's current sterilization device involves generating a non-thermal plasma/free radical effluent that can safely be delivered to infected burn injuries. Through preliminary studies, SuperPulse PPT has demonstrated the ability of this free radical sterilization system to kill microorganisms in vegetative, spore, and biofilm forms in vitro. Additionally, in vivo testing has demonstrated that this sterilization system can kill microorganisms on mammalian skin while leaving the skin itself unharmed. Thus, this device has the potential to change the current treatment paradigm of preventing burn wound infections to a low cost, side effect-free system that is efficacious against all microorganisms. The proposed study will use an established porcine model of deep dermal partial thickness burn injury to create a polymicrobial burn wound infection with Staphylococcus aureus and Pseudomonas aeruginosa, two of the common organisms causing burn wound infection in humans. Our main objective with this proposal is to demonstrate that the SuperPulse PPT free radical system is equally efficacious at preventing burn wound infection in this model as the "gold standard" topical antimicrobial Silvadene. If our hypothesis is correct, the SuperPulse PPT free radical sterilization system has the potential to change the current treatment paradigm for prevention of burn wound infection to a highly efficacious, side effect-free method that will dramatically reduce burn wound infection and its resultant morbidity and mortality. PUBLIC HEALTH RELEVANCE: Burn wound infection remains an important source of morbidity, mortality, and health care cost. Standard-of-care measures for preventing burn wound infection rely heavily on the use of topical antimicrobials, but these agents are not 100% effective and have multiple negative side effects, which has fueled the search for more efficacious methods of burn wound sterilization. SuperPulse Plasma Processing Technology has developed a totally novel free radical sterilization system by combining non-thermal plasma processing with hydrogen peroxide and ozone technologies. This unique sterilization system has the potential to change the current treatment paradigm of preventing burn wound infections to a low cost, side effect-free system that is efficacious against even the most resistant microorganisms.